Wiki Telehealth While in Hosp/Rehab facility

[GMMTimmons]

We have had a denial for 99213-95 stating that this is included with inpatient service, the telehealth is regarding her Knee pain, pt was in hosp/rehab for hip. Telehealth is with her pain management DR. Denied as inclusive, How do we separate?

 

[SharonCollachi]

You would bill with the 99231-99233 series, not 99211-99215.

 

[GMMTimmons]

You would bill with the 99231-99233 series, not 99211-99215.

Ah yes! Thank you.

 

[GMMTimmons]

You would bill with the 99231-99233 series, not 99211-99215.

Would the place of service have to be 22?

 

[SharonCollachi]

POS 22 is On Campus-Outpatient Hospital. You said they were inpatient. What exactly is their location?

 

[GMMTimmons]

The patient is in a rehabilitation facility due to a femur injury. Our physician's care for this patient is not connected to this injury nor the facility. Patient has been seeing our doctor for her lower back and bilateral knee pain.
The patient did a Telehealth visit with our physician about her back and knee pain and this claim denied as inclusive since the patient is in the facility care. How do we separate our claim from the facility?
Similar to when a Medicare patient is in Hospice care, but we see them for an unrelated issue we separate our visit with a modifier.. Could this be done in this case as well?